Medical education succeeds when one creates a culture demanding excellence and the leaders help the learners become more excellent. Medical education does not succeed because someone wrote a great curriculum. Medical education does not succeed because of strict adherence to work hours…We need educators who challenge the learners to improve daily. We need accurate positive and negative feedback for our learners—and immediate feedback, not after weeks.

In a year and a half of clinical education, I have had exactly one rotation that did this and did it well. It was a tough rotation; students worked very hard and had long hours. This rotation has also consistently won the ‘best clerkship’ award from the students. Med students and residents want thorough, tough, fair education.

But how do we create such experiences across the medical education continuum? How do you create such a culture? How do you create such passion?